{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T18:13:28Z","timestamp":1789582408562,"version":"build-2803163510"},"reference-count":10,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T00:00:00Z","timestamp":1773619200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T00:00:00Z","timestamp":1773619200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disord Clin Pract"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cognitive fluctuations (CFs) are a disabling feature in Parkinson's disease dementia (PDD) and contribute to caregiver burden. The relationship between CFs and neurogenic orthostatic hypotension (nOH), a common autonomic complication in PDD, has not been adequately examined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Cases<\/jats:title>\n                    <jats:p>We describe four patients with PDD and nOH with caregiver\u2010reported CFs manifesting as impaired attention, comprehension, language, and visuospatial skills. Each patient underwent bedside assessment for orthostatic vital signs and 24\u2010hour ambulatory blood pressure monitoring (ABPM). CFs were consistently time\u2010locked to periods of hypotension, independent of carbidopa\/levodopa dosing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Hypotensive episodes may be under\u2010recognized contributors to CFs in PDD. Interventions targeting hypotension warrant further investigation as potential strategies to mitigate CFs. Incorporation of ABPM into routine clinical evaluation may help guide their management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mdc3.70590","type":"journal-article","created":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T10:28:51Z","timestamp":1773656931000},"page":"1967-1971","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Hypotensive Episodes Precede Cognitive Fluctuations in Parkinson's Disease Dementia"],"prefix":"10.1002","volume":"13","author":[{"given":"Jorge","family":"Patino","sequence":"first","affiliation":[{"name":"James J. and Joan A. Gardner Family Center for Parkinson's Disease and Movement Disorders, Department of Neurology &amp; Rehabilitation Medicine University of Cincinnati  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Duque","sequence":"additional","affiliation":[{"name":"James J. and Joan A. Gardner Family Center for Parkinson's Disease and Movement Disorders, Department of Neurology &amp; Rehabilitation Medicine University of Cincinnati  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesus","family":"Abanto","sequence":"additional","affiliation":[{"name":"James J. and Joan A. Gardner Family Center for Parkinson's Disease and Movement Disorders, Department of Neurology &amp; Rehabilitation Medicine University of Cincinnati  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron","family":"Bloemer","sequence":"additional","affiliation":[{"name":"James J. and Joan A. Gardner Family Center for Parkinson's Disease and Movement Disorders, Department of Neurology &amp; Rehabilitation Medicine University of Cincinnati  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heba","family":"Deraz","sequence":"additional","affiliation":[{"name":"James J. and Joan A. Gardner Family Center for Parkinson's Disease and Movement Disorders, Department of Neurology &amp; Rehabilitation Medicine University of Cincinnati  Cincinnati Ohio USA"},{"name":"Department of Neurology Cairo University Hospitals  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto J.","family":"Espay","sequence":"additional","affiliation":[{"name":"James J. and Joan A. Gardner Family Center for Parkinson's Disease and Movement Disorders, Department of Neurology &amp; Rehabilitation Medicine University of Cincinnati  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8807-6672","authenticated-orcid":false,"given":"Abhimanyu","family":"Mahajan","sequence":"additional","affiliation":[{"name":"James J. and Joan A. Gardner Family Center for Parkinson's Disease and Movement Disorders, Department of Neurology &amp; Rehabilitation Medicine University of Cincinnati  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,16]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awz311"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.27268"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.25170"},{"key":"e_1_2_8_5_1","unstructured":"OkunM.Tips For Identification And Treatment Of Cognitive Fluctuations In Parkinson's Disease; Accessed September 12 2023https:\/\/www.parkinsonsecrets.com\/blog\/2021\/12\/6\/tips-for-cognitive-fluctuations-in-parkinsons-y5hl4."},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.30044"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.124.23188"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.0000000000003452"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.25923"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10286-024-01030-7"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/braincomms\/fcaf310"}],"container-title":["Movement Disorders Clinical Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mdc3.70590","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/mdc3.70590","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mdc3.70590","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T08:36:14Z","timestamp":1786782974000},"score":1,"resource":{"primary":{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/10.1002\/mdc3.70590"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,16]]},"references-count":10,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1002\/mdc3.70590"],"URL":"https:\/\/doi.org\/10.1002\/mdc3.70590","archive":["Portico"],"relation":{},"ISSN":["2330-1619","2330-1619"],"issn-type":[{"value":"2330-1619","type":"print"},{"value":"2330-1619","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,16]]},"assertion":[{"value":"2025-12-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}